What happens once Brain Stem Death is declared ?

Organ donations require prior consent from the donor's family. In India, according to the Transplantation of Human Organs & Tissues Act 1994, the next of kin of the patient will decide whether to donate their organs and tissues.

Once a person is declared brain stem dead, the transplant coordinator of the hospital will counsel the family and give them the option of donating organs and tissues. The family may or may not agree and can, till the last minute before retrieval, change their mind about donating. It has been noted that a lot of families, even in the face of devastating loss, agree to organ donation to save the lives of others. For them, it is the only good thing that could come out of the death of a loved one, and for this reason alone, it is everyone absolute right to be asked if they want to donate.

Request for Organ Donations & Counselling of Families

Usually, the organ donation request is made in the time interval between the diagnosis of brain stem death and cardiac death. According to law, doctors are required to take the family members’ consent before retrieving organs, even if the brain stem dead patient has pledged his or her organs. The doctor on duty is required by law to ask for the organs from the relative in case of brain stem death.

Brain stem death is relatively a new concept and making a request for organ donation in these circumstances can be an extremely difficult task for a doctor or a nurse to undertake. If the deceased carry a Donor Card (a card the size of a credit card expressing their desire for organ donation) the task of asking for organ donation becomes easier.

If the relatives are agreeable, the process of organ donation is undertaken and vital organs like the heart, lungs, liver, pancreas and kidneys are removed for transplantation. The process of organ donation and transplantation requires coordination between different teams operating almost simultaneously and sometimes in different locations. It may require getting surgeons from different specialities together for both donor and recipient surgery.

Police NOC & Post-mortem in Medico-Legal Cases

In medico-legal cases, to proceed with organ donation, a police NOC is required. And the same must be intimated to the designated forensic expert responsible for conducting the post-mortem. The forensic expert can be present during the retrieval of the organs and conduct the post-mortem simultaneously or the retrieving doctor makes notes of the retrieved organs which will form a part of the post-mortem report, and the body is sent to the forensic expert for completion of post- mortem formalities.